Breast Cancer - Arab Medical Association Against Cancer

Staging and end results of therapy 41PEV 1 These are the cases which are apparently the least serious but also the mostdifficult to define. They are differentiated from the usual “chronic” type ofbreast cancer by one essential and unique characteristic “the rapid rate ofgrowth”.PEV 0 These are the cases, which correspond to the classic “chronic” type ofbreast cancer but they lack the previously-mentioned activity signs.It is therefore admitted that any tumor with its apparent volume doubled in 6months is to be considered in evolution (progressive). The determination of thischaracteristic is based on the interrogation of the patient and thus, its appreciation issubjective. Such evaluation is impossible for recently discovered tumors. However,skin biopsy for involvement of skin lymphatics by tumor cells is a more reliablemethod to assess the stage of evolution.Inflammatory CarcinomaInflammatory carcinoma of the breast was described by Lee as a distinct entity.This disease form is reported to account for 1% to 10% of breast malignancies andcan be divided into two types: the primary type, in which inflammatory changesappear simultaneously with the carcinoma in an otherwise normal breast, and thesecondary type in which the inflammatory manifestations appear in a breast withlong standing carcinoma. The common factor in all such cases is the unusualappearance of widespread redness and edema in the skin, usually without anyincrease in the patient’s temperature and with no change in the white blood count.This inflammatory type corresponds to types PEV3 and PEV2 mentioned above.End Results of Therapy (National Cancer Institute, Cairo)A Follow up study was conducted on a total of 408 female patients with operablebreast cancer treated in National Cancer Institute, Cairo (NCI) during the periodJanuary 1980-December 1983. All patients except 6 were subjected to radicalmastectomy at that time; 224 patients received adjuvant postoperative radiotherapyand 73 patients were treated by adjuvant CMF combination for 6 courses. Thisadjuvant regimen was conducted in relation to tumor size and lymph node affection.In June 1987 multivariate analysis was carried out where multiple stepwiseregression analysis was done on the various prognostic factors to elicit theprognostic index. In our study, age had no effect on survival similar to the resultsobtained by Rosen et al. and Muscolino et al. This was in disagreement with theresults of Palmer et al. who found a better survival rate of patients ranging from 40-49 years of age than older patients in stage I and II of the disease.